Individual provider Active NPI

William G Rasberry, NP

  • Nurse Practitioner
  • Ruston, LA
National Provider Identifier
1891020129
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP05938 Issued in LA
Practice address
1200 S Farmerville St
Ruston, LA 71270-5941
Phone
(318) 251-6216
Fax
(318) 251-6257
NPI assigned
Oct 5, 2009
Last updated
Oct 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP05938 LA Primary

Addresses

Primary practice location

1200 S Farmerville St
Ruston, LA 71270-5941

Mailing address

1200 S Farmerville St
Ruston, LA 71270-5941
Phone (318) 251-6216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000489 LA Practitioner - Nurse Practitioner 4587703640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Professionals LLCGroup PAC ID 8224494166, 4 clinicians

Practice addresses (Care Compare)

4396 Hwy 80
Ruston, LA 71270-8948
Phone (318) 237-0785

5505 Shreveport Hwy
Pineville, LA 71360-3533
Phone (337) 381-0956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Professionals LLC CurrentSince Feb 4, 2023 Accepting new patients

Locations

501 W Saint Mary Blvd
Ste 308
Lafayette, LA 70506
Phone (318) 983-0010

5505 Shreveport Hwy
Pineville, LA 71360
Phone (318) 441-5900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1891020129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-251-6216",
            "fax_number": "318-251-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-251-6216",
            "fax_number": "318-251-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASBERRY",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP05938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.